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An MIT-led research team has developed a drug capsule that could be used to deliver oral doses of insulin, potentially replacing the injections that people with type 1 diabetes have to give themselves every day.

About the size of a blueberry, the capsule contains a small needle made of compressed insulin, which is injected after the capsule reaches the stomach. In tests in animals, the researchers showed that they could deliver enough insulin to lower blood sugar to levels comparable to those produced by injections given through skin. They also demonstrated that the device can be adapted to deliver other protein drugs.

“We are really hopeful that this new type of capsule could someday help diabetic patients and perhaps anyone who requires therapies that can now only be given by injection or infusion,” says Robert Langer, the David H. Koch Institute Professor, a member of MIT’s Koch Institute for Integrative Cancer Research, and one of the senior authors of the study.

Giovanni Traverso, an assistant professor at Brigham and Women’s Hospital, Harvard Medical School, and a visiting scientist in MIT’s Department of Mechanical Engineering, where he is starting as a faculty member in 2019, is also a senior author of the study. The first author of the paper, which appears in the Feb. 7 issue of Science, is MIT graduate student Alex Abramson. The research team also includes scientists from the pharmaceutical company Novo Nordisk.

Self-orientation

The tip of the needle is made of nearly 100 percent compressed, freeze-dried insulin, using the same process used to form tablets of medicine. The shaft of the needle, which does not enter the stomach wall, is made from another biodegradable material.

Within the capsule, the needle is attached to a compressed spring that is held in place by a disk made of sugar. When the capsule is swallowed, water in the stomach dissolves the sugar disk, releasing the spring and injecting the needle into the stomach wall.

The stomach wall has no pain receptors, so the researchers believe that patients would not be able to feel the injection. To ensure that the drug is injected into the stomach wall, the researchers designed their system so that no matter how the capsule lands in the stomach, it can orient itself so the needle is in contact with the lining of the stomach.

“As soon as you take it, you want the system to self-right so that you can ensure contact with the tissue,” Traverso says.

The researchers drew their inspiration for the self-orientation feature from a tortoise known as the leopard tortoise. This tortoise, which is found in Africa, has a shell with a high, steep dome, allowing it to right itself if it rolls onto its back. The researchers used computer modeling to come up with a variant of this shape for their capsule, which allows it to reorient itself even in the dynamic environment of the stomach.

“What’s important is that we have the needle in contact with the tissue when it is injected,” Abramson says. “Also, if a person were to move around or the stomach were to growl, the device would not move from its preferred orientation.”

Once the tip of the needle is injected into the stomach wall, the insulin dissolves at a rate that can be controlled by the researchers as the capsule is prepared. In this study, it took about an hour for all of the insulin to be fully released into the bloodstream.

Researchers have identified genetic variants associated with obesity that is central to developing targeted interventions to reduce the risk of chronic illnesses like hypertension, Type-2 diabetes and heart disease.

The team from the University of North Carolina at Chapel Hill found genetic sites that affect human body’s size and shape, including height and obesity. The findings will help understand how genes can predispose certain individuals to obesity.

In the study, published in the journal Nature Genetics, researchers found 24 coding loci (or positions) — 15 common and nine rare — along chromosomes of individuals that predispose to higher waist-to-hip ratio.

Higher values of waist-to-hip ratio are associated with more incidence of diseases associated with obesity.

“For the first time, we were able to examine, on a large scale, how low-frequency and rare variants influence body fat distribution,” said North.

“A better understanding of the genetic underpinnings of body fat distribution may lead to better treatments for obesity and other downstream diseases obesity also impacts, for example Type-2 diabetes and heart disease,” suggested North.

Further analysis revealed pathways and gene sets that influenced not only metabolism but also regulation of body fat tissue, bone growth and adiponectin, a hormone that controls glucose levels and breaks down fat.

Performing functional studies across other organisms, the team also identified two genes that were associated with significant increase in triglyceride and body fat across species.

Scientists from Aberdeen University are hoping to find a way to prevent or postpone the onset of Type 2 Diabetes.

However, the innovative study will not be able to go ahead unless enough volunteers come forward to participate.

A team from the Rowett Institute will be examining whether food supplements containing bilberry and grape seed extract could lower blood glucose and cholesterol levels in people that may be at risk of developing Type 2 diabetes.

The researchers also want to record whether characteristics such as gender, age, body weight, genes and lifestyle factors play a part in how bodies respond to the supplements.

Dr Baukje de Roos is leading the study with Teresa Grohmann, and said: “We really hope to work with people who may be at risk to getting diabetes, and work to find a method of preventing it.

“We’re taking a personal approach, as previous studies have shown that people are affected in many different ways to dietary advice and studies.

“Type 2 diabetes is an important risk factor for cardiovascular disease, therefore preventing it at an early stage is important.”

Diabetes currently affects one in 25 people in Scotland, according to current statistics.

However, the figure could be as high as 250,000 as it is estimated that 20,000 people in Scotland remain undiagnosed.

As in many countries, type 2 diabetes is rapidly increasing in Scotland and accounts for about 87% of diabetes in Scotland.

Dr Roos added: “By improving glucose and lipid markers in the blood, we are hoping to postpone or prevent the onset of Type 2 diabetes.

“In order to test our theory we really need help from members of the public, who might be willing to volunteer to take part in our research study.”

TYPE 2 diabetes is caused by having too much sugar in the blood, which happens due to problems with the body’s production of insulin. There are some risk factors which can increase the chance of this happening, and one study has revealed working for a certain number of hours per week may raise the risk.

Type 2 diabetes is often linked to being overweight, putting people who follow a poor diet and don’t exercise regularly more at risk of developing the condition.

However, according to a study by medical website Treated.com, working long hours may also increase the risk of getting type 2 diabetes.

Using data from the OECD and WHO for 39 countries across the world, Treated.com observed that overall diabetes prevalence was higher on average in nations with a working week of more than 37.5 hours.

The five countries with the longest working weeks were Colombia, Turkey, Costa Rica, Mexico and South Africa.

In these five countries, the percentage of females who were overweight was higher than the percentage of males who were overweight.

But, interestingly, in the majority of countries with a shorter working week of 37.5 hours or less, the percentage of males who were overweight was significantly higher than the percentage of females who were overweight.

Treated.com Clinical Director Dr Daniel Atkinson said the findings could be a result of the fact that people who work longer hours have less time to prepare healthy food, forcing them to rely on unhealthy ready meals or fast food.

“An argument can be made that, the longer hours a person works, the less time they will have to make considered food choices or prepare their own food; and the more likely they are to rely on more convenient, typically unhealthy options (for example processed ready meals, takeout, or fast food),” said Dr Atkinson.

According to the NHS, following a healthy diet and keeping active can help to manage blood sugar levels, minimising the risk of developing type 2 diabetes.

People who already have type 2 diabetes are also advised to improve their diet and exercise more in order to lower blood sugar levels.

Type 2 diabetes is a lifelong condition and can’t be cured, but following a healthy lifestyle can help to lower blood sugar levels and keep the condition under control.

Medication can also be prescribed for people with type 2 diabetes to prevent complications from occurring.

The NHS advises eating a wide range of foods, including fruit, vegetables and some starchy foods like pasta, while keeping sugar, fat and salt to a minimum.

The health body also advises aiming for 2.5 hours of physical activity per week.

“There are so many possible factors involved in the development of type 2 diabetes, it is difficult for research to draw a definite causal link between the condition and longer average working time,” said Dr Atkinson.

“But the correlation does raise some interesting questions around our attitudes to work, how we cope with an increased workload, and moreover what’s expected of us as employees.”

Drivers who treat their diabetes with insulin will have greater choice in how they test their glucose levels under new guidelines published today by the DVLA.

The update means drivers can now choose to use flash and continuous glucose monitoring devices to take glucose readings before they drive, or during breaks in driving. Until now, drivers had to check their glucose levels with a finger prick blood reading no more than 2 hours before driving and then again on a break after every 2 hours of driving.

DVLA Chief Executive Julie Lennard said:

We want to make it as safe and as easy as possible for drivers to get on the road. Our panel of medical experts who help set the medical standards for driving are always looking at how we can use advancing technologies, and we’re pleased to be able to offer drivers another way of how they monitor their glucose levels.

The guidelines have been updated following discussions with the Secretary of State for Transport’s Honorary Medical Advisory Panel on driving and diabetes mellitus. The panel consists of leading medical experts in diabetes, DVLA doctors, lay members and observers from other organisations. It works together with the DVLA to provide expert advice with the aim of maintaining and improving road safety.

Nikki Joule, Policy Manager at Diabetes UK, said:

The new guidance, which means that Flash Glucose Monitoring and Continuous Glucose Monitoring can be used in driving, is a major victory for people with diabetes.

Innovative technologies such as these make people’s lives easier, because they improve their ability to monitor their blood glucose levels day-to-day and manage their condition safely, including whilst driving.

We look forward to keep on working with the DVLA to make sure people living with diabetes are treated fairly, and that everyone is able to hold a driving licence if they meet medical fitness standards.

About

Silver Star Diabetes is a registered charity campaigning to provide diabetes awareness. The Charity runs Mobile Diabetes Units which main role is to to carry out important diabetes testing and to promote culturally sensitive healthcare in the major towns and cities of Britain.
There are currently over 3 million people diagnosed with diabetes in the UK and another over 1 million people who have type 2 diabetes but do not yet know it.